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The main components of the gastric tumor stroma consist of cells in both the immune and non-immune microenvironments. The effectiveness of a series of therapeutic measures such as adjuvant chemotherapy is closely related to the composition of gastric tumor stroma. By analyzing the components in the gastric tumor stroma, we understand the characteristics of the constituents in the pathological structure of gastric cancer, and further explore the connection of each component of the stroma with pathological structure and regulatory mechanisms of stroma components on the occurrence and progression of gastric tumors. Combined with artificial intel-ligence technology to analyze the pathological features related to stroma components of tumor microenvironment, the dynamic changes of immune microenvironment and non-immune microen-vironment in gastric cancer are expected to reveal.
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Hepatocellular carcinoma has a high morbidity and mortality, which has seriously harmed human health. Several targeted therapies have been approved for the first- and second-line treatment of advanced hepatocellular carcinoma. The emergence of immunotherapy has brought the treatment of hepatocellular carcinoma into a new era. Targeted and immunotherapeutic agents have synergistic effects in mechanism, also the combination of these two therapies has been clinically beneficial to patients with advanced hepatocellular carcinoma. At the same time, in addition to the systemic therapy of targeted combined immunological, applying appropriate local therapy can provide a longer survival period or even a chance of cure for that some patients. The authors introduce the diagnosis and treatment of a case of advanced hepatocellular carcinoma who achieved pathological complete remission by first-line immunotherapy combined with anti-angiogenesis targeted therapy.
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Introduction: SARS-CoV-2 is an unknown corona virus causing COVID-19 disease responsible for the ongoing pandemic affecting over 190 countries, with a mortality rate of about 5%. The high mortality rate resulted from its ability to elicit cytokine storm via non-specific immune response with delay in specific immune response, notably worst in the elderly, HIV, immunocompromised and cancer diseased patients. The article therefore provides frontline health care workers, the opportunity to understand and equip themselves with management options, public health measures used in coping with COVID-19 infections and enables personnel to make quick preparation for Symptomatic COVID-19 infection in-order to reduce mortalities in health facilities. It also provides a summarised teaching material for medical and allied health students around the world.Methodology: Credible data and information were obtained from the World health organization situation report, Johns Hopkins University Corona Virus resource centre and other notable journal publications. Most information wason public domain.Results: Clinical featuresreported include pneumonia, renal dysfunction, hepatobiliary dysfunction and residual tissue damage, especially in the lungs in those that survive. The literature highlights the blood work-up picture (Leucopenia, increased cytokines IL-6, ferritin, Serum creatinine, urea, AST, GGT, ALT and Viremia) and radiological features of the disease. ELISA and RT-qPCR test are required for diagnosis using sputum, or pharyngeal swab, blood, serum, urine and faecal samples which lead to faeco oral transmission. ELISA/R PCR is also required for disease exclusions in coexisting epidemics such as MERS-CoV, SARS-COV and other viral diseases.Treatment modalities employed thus far are trials that have produce results including targeted therapy, anti-retroviral, Favipiravir, Remdesivir, antibody-serum and antimalaria drugs such as chloroquine and quinine which are found among some protocols in African setting and other developing countries. Currently, ongoing preventive measures (face mask, social distancing and hand hygiene, community testing, isolation of confirmed cases and tracking of the exposed, remain the key corner stone in the management of COVID-19 pandemic.Conclusion:COVID-19 disease still remain unclear to many scientists and its pandemic still ongoing. There are many research and clinical trials ongoing while some drugs are used off in-order to mitigate the damage caused by the virus in Human body. Cytokine storm needs immunomodulators and viral targeted therapy as discussed in-order to reduce tissue damage, and eventually morbidity and mortalities from COVID-19 infections.
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Resumen: Introducción: La Hidradenitis palmoplantar ecrina idiopática (HPPI) es una dermatosis neutrofílica infrecuente, que cursa con nódulos eritematosos dolorosos de comienzo brusco en regiones plantares o palmoplantares, en niños que no tienen otra enfermedad subyacente. Objetivo: Presentar un caso que ilustra las principales características clínicas e histológicas de la HPPI. Caso Clínico: Niña de 11 años evaluada por nódulos eritematovioláceos dolorosos en planta de pie derecho de 48 horas de evo lución y fiebre de hasta 38,2 °C, sin antecedentes de interés salvo hiperhidrosis y práctica intensa de ejercicio en los días previos. Ante la sospecha clínica de HPPI se realizó biopsia cutánea, que mostró infiltrado inflamatorio neutrofílico alrededor de glándulas sudoríparas ecrinas y abscesos de neutrófilos, confirmando el diagnóstico. Se indicaron antiinflamatorios no esteroidales orales y reposo, con resolución de las lesiones en 7 días. Conclusiones: Este caso demuestra los aspectos más importantes de la HPPI. Esta entidad en muchos casos es infradiagnosticada, dado que puede confundirse con otras patologías que también cursan con nódulos acrales dolorosos, pero tienen distintas implicacio nes patogénicas y terapéuticas. Identificar apropiadamente la HPPI permite evitar la alarma innece saria, tanto en pacientes y sus padres, como en los propios dermatólogos y pediatras.
Abstract: Introduction: Idiopathic Palmoplantar Eccrine Hidradenitis (IPPH) is a rare neutrophilic derma tosis, with painful erythematous nodules of sudden onset in the plantar or palmoplantar region, in children without other underlying diseases. Objective: To present a case that shows the main clinical and histological characteristics of this entity. Clinical Case: 11-year-old girl with a 48-hours history of painful erythematous-violaceous nodules on the right foot plant associated with fever of up to 38.2 °C, with no history of interest except hyperhidrosis and intense exercising on previous days. Given the clinical suspicion of IPPH, a skin biopsy was performed, which showed inflammatory neutrophil infiltration around eccrine sweat glands and neutrophilic abscesses, confirming the diagnosis. Oral NSAIDs and rest were prescribed, with resolution of the lesions in 7 days. Conclusions: This case demonstrates the most important aspects of this entity, in many cases underdiagnosed, since it can be confused with other pathologies that occur with painful acral nodules, but have different pathogenic and therapeutic implications. To properly identify the IPPH allows preventing an unnecessary alarm, both patients and their parents, as in dermatologists and pediatricians themselves.
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Humans , Female , Child , Hidradenitis/diagnosis , Foot Dermatoses/diagnosis , Hidradenitis/complications , Hidradenitis/pathology , Acute Pain/etiology , Foot Dermatoses/complications , Foot Dermatoses/pathologyABSTRACT
Resumen: la obesidad constituye un problema mayor de salud pública relevante en la actualidad, considerando que cumple un doble rol al actuar como factor de riesgo para la mayoría de las enfermedades crónicas no transmisibles y constituir una entidad nosológica independiente. Los estudios de imágenes han contribuido, desde diferentes perspectivas, a dilucidar los mecanismos propios de la enfermedad, sus complicaciones, progresión, mecanismos cognitivos involucrados y respuesta a diversos esquemas terapéuticos. El objetivo del presente artículo es proveer de una visión general respecto a cómo los estudios imagenológicos, especialmente basados en resonancia magnética, han profundizado la comprensión de los mecanismos metabólicos y neurocognitivos, relacionados, así como elementos vinculados al tratamiento. Adicionalmente se discuten posibles direcciones futuras en este campo.
Abstract: Obesity constitutes a relevant issue in public health. It acts both like a risk factor for most of the non-communicable diseases and as an independent nosologic entity. The imaging studies have contributed, from several perspectives, to elucidate the underlying mechanisms of the disease. its complications, progression, involved cognitive phenomena and the response to different therapeutic approaches. The objective of this article is to provide a global view about how the imaging studies, particularly those based on magnetic resonance imaging, have given a deeper comprehension of the related metabolic and cognitive mechanisms and some facts related to the treatment. Additionally, future directions of this field are discussed.
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Humans , Obesity/diagnostic imaging , Magnetic Resonance Imaging , Obesity/physiopathology , Obesity/therapyABSTRACT
Primary biliary cholangitis (PBC) is a chronic, non-suppurative, autoimmune cholestatic group of liver disorder, which more frequently affects middle-aged women and eventually leads to liver failure. Its pathogenesis is not completely clear, yet the study has confirmed that the occurrence and development of PBC is closely associated to the individual's genetic background, with obvious genetic heterogeneity. Currently, PBC has been divided into five types based on their related genes dissimilarities, aside from PBC-1, which is an autosomal dominant inheritance, while the other four types of inheritance are unidentified. The ratio of middle-aged women to male cases with PBC goes overs 9:1, and it mostly occurs in perimenopausal period. It is speculated that the occurrence of PBC may be related to estrogen and estrogen receptors. This article reviews the advances in the study of genetic theory of PBC and the role of estrogen and its receptor in this disease.
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Hypertension (HTN) is a complex multi-factorial disease and is considered one of the foremost modifiable risk factors for stroke, heart failure, ischemic heart disease and renal dysfunction. Over the past century, salt and its linkage to HTN and cardiovascular (CV) mortality has been the subject of intense scientific scrutiny. There is now consensus that different individuals have different susceptibilities to blood pressure (BP)-raising effects of salt and this susceptiveness is called as salt sensitivity. Several renal and extra-renal mechanisms are believed to play a role. Blunted activity of the renin–angiotensin–aldosterone system (RAAS), adrenal Rac1-MR-Sgk1-NCC/ENaC pathway, renal SNS-GR-WNK4-NCC pathway, defect of membrane ion transportation, inflammation and abnormalities of Na+/Ca2+ exchange have all been implicated as pathophysiological basis for salt sensitive HTN. While salt restriction is definitely beneficial recent observation suggests that treatment with Azilsartan may improve salt sensitivity by selectively reducing renal proximal tubule Na+/H+ exchange. This encourages the future potential benefits of recognizing and therapeutically addressing the salt sensitive phenotype in humans.
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[Objective]On the origin and development of stroke research and interpretation. [Methods]Reading from pre-Qin period to the Ming and Qing dynasties in the ancient literature related to stroke the literature, according to the treatment of disease, etiology, pathogenesis, therapeutic principle, prevention and curing of Chinese medical induction, summary, combining the origin of stroke, analysis of pathogenesis and therapeutic principle of stroke, and it is filtered and classified the ancient literature and research, summarizes the extraction.[Methods]Reading and analyzing ancient documents related to the stroke.[Results]The termstrokeand theoretical source inNei Jing, the treatment based on syndrome differentiation is initiated Treatise on Febrile and Miscellaneous Diseases.Jin and Yuan dynasties developed stroke theory;modern perfect stroke syndrome differentiation system. Previously, during the Tang and Song dynasties, it is mainly based on the theories of vital Qi deficiency,pathogenic wind into the argument, treatment of strengthening the body and removal of scattered wind. After the Jin Yuan dynasties, they are internal injury based, wind from the endogenous theories. the treatment is mainly focused on internal injuries. [Conclusion]That ancient physicians paid attention to the etiology and treatment of stroke more, keeping in good health and prevention mentioned less, so we should pay attention to the prevention and recovery.
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OBJECTIVE:To investigate the effects of neoadjunctive chemotherapy(NAC)of docetaxel and epirubicin com-bined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METH-ODS:A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type(23 cases),Luminal B type(21 cases),basal-like type(11 cases),HER2-over expressing type(18 cases)and normal breast-like type(15 cases)according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles(21 d as a cycle). Total response rates and patho-logical complete remission(pCR)rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA,CA125,CA153] were compared before and after treatment,and the occurrence of ADR was record-ed. RESULTS:Total response rate of 88 patients was 63.64%,among which that of basal-like breast cancer patients was 72.73%, significantly higher than other molecular types,with statistical significance(P0.05). The pCR rate of 88 patients was 27.27%,and that of basal-like breast cancer patients was the highest(45.45%). There was statistical significance in pCR rates of pairwise molecular type compari-son(P0.05). Before treatment,there was no statistical significance in the expression of CEA,CA125 and CA153 in breast can-cer patients with different molecular types(P>0.05). After treatment,the expression of CEA,CA125 and CA153 in different mo-lecular types were decreased significantly,with statistical significance(P0.05). There was no statistical significance in the incidence of ADR among different molecular types(P>0.05). CONCLUSIONS:NAC plan of docetaxel and epirubicin combined with cyclophospha-mide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different mo-lecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types,so NAC plan is the preferred treatment for basal-like type breast cancer.
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Autoimmune hepatitis (AIH) is liver parenchymal inflammation mediated by the autoimmune response of hepatocytes. Its clinical features include elevation of aminotransferases in serum, presence of various autoantibodies in circulation, hypergammaglobulinemia, and interface hepatitis in liver tissue. Although the etiology and pathogenesis of AIH have not been fully elucidated, a consensus has been reached on the theories of "genetic susceptibility" and "molecular simulation" , and "immunoregulatory disorder" remains a hot research topic for many scholars. This article reviews the research advances in the theories of "genetic susceptibility" , "molecular simulation" , and "immunoregulatory disorder" .
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Objective To analyze the genomic evolution characteristics of pathogenicity islands (PAIs)in Deng strain of enteropathogenic Escherichia coli (E.coli,EPEC Deng).Methods EPEC Deng was isolated from infant stool specimen,serotypes were identified and antimicrobial susceptibility testing was performed;whole-genome se-quencing was performed by Illumina 2000 system,the locations of prophages(PPs)in the chromosome were detected using PHAST software,collinearity analysis was performed by MUMmer software,phylogenetic trees of homolo-gous gene were constructed in order to understand the evolutional rule of homology gene.PAIs prediction was per-formed using PAI finder software,the homologous evolutionary rule of PAIs core region(LEE)and core genes were clarified,genetic polymorphism was analyzed.Results The serotype of EPEC Deng strain was O119:H6,the strain was resistant to ciprofloxacin,levofloxacin,and ampicillin,but sensitive to other antimicrobial agents.The complete circular chromosome contained 5 025 482 bp with a GC content of 50.52 %,and the plasmid contained 207 564 bp with a GC content of 49.50%.A total of 17 PPs in the chromosomal genome were discovered,phyloge-netic trees analysis suggested that EPEC Deng strain was highly homologous with O26:H11 and O111 :H strains;PAIs and core genes were highly homologous with RDEC-1 and O26:H413/89-1 strains;genetic diversity analysis showed that the intimin (eae)and its receptor tir had high polymorphism,with the pi (π)value>0.10,the genes in type III secretion system was relatively stable.Conclusion The study clarified the genomic evolution characteris-tics of EPEC Deng genome and it’s PAIs,and is helpful for understanding genetic characteristics of native EPEC.
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Acute kidney injury (AKI), a common clinical dis-ease, is one complex pathophysiological process. In this review paper, the relationship and the molecular mechanisms of ische-mia-reperfusion, major surgery, rhabdomyolysis, pus sepsis and drug-induced renal toxicity associated with AKI were comprehen-sively reviewed. In addition, the prevention and treatment of AKI by Chinese medicine and the effective components were also reviewed. Therefore, our review aims to provide valuable infor-mation for treatment of AKI, and also for exploration of innova-tive new drugs.
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[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.
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ABSTRACT:Objective To investigate whether medial cerebellar nucleus may be involved in the pathogenesis of post-stroke depression (PSD)and explore the pathway that mediates this effect.Methods Healthy SD rats were randomly divided into five groups:control group,stroke group,PSD group,medial cerebellar nucleus (Med)lesion group,and superior cerebellar peduncle (xscp)lesion group.The ethological score of depression was evaluated.The neurotransmitters of Glu and GABA in the lateral hypothalamic area were detected by high performance liquid chromatography.Results Compared with those in control group,the levels of GABA and Glu expressions did not significantly differ in the lateral hypothalamic area in stroke group (P > 0.05 ).In contrast,the levels in PSD group,Med lesion group and xscp lesion group were lower than those in stroke group to different extent (P <0.01). Conclusion These results preliminarily show that medial cerebellar nucleus may participate in the pathogenesis of post-stroke depression,which may be mediated by the cerebellum-hypothalamic pathway.
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Purpose To investigate the expression pattern and c1inicopatho1ogica1 significance of D2-40 in craniopharyngioma( CP). Methods Immunohistochemica1 method was used to assess D2-40 expression in 126 cases of craniopharyngioma. Statistic software was used to ana1yze the corre1ation between D2-40 expression and c1inicopatho1ogica1 features. Results The overa11 positive rate of D2-40 expression in 126 craniopharyngioma was 87. 30%. The rate of +, and were 44. 44%( 56/126 ),37. 30%( 47/126 )and 5. 56%(7/126)respective1y. In adamantinomatous CPs,D2-40 expression was observed in epithe1ia1 components corresponding to the stratum intermedium,whi1e in papi11ary CPs,it was immuno-positive in basa1 ce11s. With the increasing of the existence of inf1amma-tion in tumor,D2-40 expression was up-regu1ated. Tumor ce11s were over-expressed for D2-40 in basa1 ce11s and stratum intermedium ce11s of the invasive frontier. D2-40 expression was higher in the invasive craniopharyngioma than in the non-invasive craniopharyngio-ma. In addition,D2-40 expression was higher in the recurrent craniopharyngioma than in the non-recurrent craniopharyngioma. There were no significant re1ationship between D2-40 expression and gender,and histo1ogica1 c1assification of tumors. Conclusions D2-40 expression is associated with the deve1opment of craniopharyngioma,which can 1ead to enhance the tumor ce11 invasion,and may be re-1ated to inf1ammation-re1ated mechanisms. D2-40 expression may be one of the recurrence factors in patients with craniopharyngioma.
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Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.
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Homocysteine ( Hcy) is an independent risk factor for a variety of diseases and closely related to cardiac-cerebralvascu-lar diseases, neurological diseases, diabetes and diabetic com-plications. High homocysteine levels can significantly increase the recurrence risks of cardiac-cerebralvascular events and stroke in patients with stroke, leading to high all-cause mortality. The risk of Alzheimer’s disease is increased by 1. 8 fold when the concentration of Hcy is over 14 μmol·L-1 . For each 5 μmol· L-1 increase in plasma Hcy in diabetes patients, the mortality rate increases by 5 fold in the next five years. High Hcy triggers the pathogenesis of diseases via multiple mechanisms including oxidative stress, lesions of vascular endothelial cells, prolifera-tion of vascular smooth muscle cells, dysfunction of coagulation and lipid metabolism and genomic hypomethylation etc.
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Objective To realize the incidence of healthcare-associated infection(HAI)in patients after receiving extracorporeal membrane oxygenation(ECMO)procedure,and to evaluate the related factors for HAI.Methods Clinical data of patients receiving ECMO from January 2003 to December 2012 were collected and analyzed retro-spectively.Results Of 43 patients receiving ECMO,15 (34.88% )developed 24 times(55.81% )of HAI. The main HAI site was lower respiratory tract(n= 12,50.00% ),followed by blood stream(n= 6,25.00% ),skin and soft tis-sue(n= 5,20.83% ).A total of 28 isolates of pathogens were detected,gram-negative bacilli were 19(67.86% )iso-lates,gram-positive cocci 7(25.00% ),and fungi 2(7.14% );pathogens were mainly isolated from specimens of sputum(n= 12,42.86% ),blood (n= 9,32.14% )and wound secretion(n= 6,21 .43% ). The incidence of postopera-tive HAI in ECMO patients was related with patients’age,duration of ECMO,complication,mechanical ventila-tion,tracheal intubation or tracheotomy,and indwelling urinary catheter.Conclusion HAI in patients receiving EC-MO is high,hospital should take corresponding prevention and control measures targeting to the related risk factors of infection,so as to reduce the incidence of HAI after the ECMO.
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De Husserl a Ricoeur, constituyen temáticas que nos convocan hoy, aniversario de la publicación de Idea I Husserl, centenario del nacimiento de Ricoeur y de la publicación de la Psicopatología. ¿Qué importancia han tenido estos autores en la reflexión psicológica y psicopatológica? El recorrido que pasa por el describir, comprender y explicar en Dilthey y Jaspers hasta Binswanger, obliga sin embargo a realizar un giro, una torsión en el interpretar de Ricoeur. Se abren entonces senderos no marcados aún, "Holzwege" diría Heidegger, que nos lanzan a nuevas lecturas.
From Husserl's to Ricoeur's thought, there are topics that call for us today, anniversary of the publication of Husserl's Idea 1,100th anniversary of Ricoeur' birth and the publication of Jaspers' Psychopathology. What's the importance of these authors in Psychological and Psychopathological reflection? The tour goes through describing, understanding and explaining in Dilthey and Jaspers to Binswanger. It forces however to make a turn, a twisting in the interpreting of Ricoeur. Then, it opens paths not marked yet, "Holzwege", Heidegger would say, throwing us to new readings.
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Humans , Comprehension , Narration , PsychopathologyABSTRACT
Taking global minimum essential requirements(GMER)as standard,school of basic medical science in Wuhan University paid more attention to the cultivation of students' professional skills, innovation ability and communication ability. ‘Response to injury’integrated course was carried out. Based on the immunology,this course involves pathology and pathophysiology and explores the mecha-nism of the diseases' diagnosis and treatment. It took small classes,bilingual education,literature read-ing ,experiments and discussions in various forms . This reform aimed to improve the immunology , pathology and pathophysiology teaching and make our medical education meet the process of globalization.